Provider Demographics
NPI:1124061924
Name:ANIKWUE, CHARLES CHIKE (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:CHIKE
Last Name:ANIKWUE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 680447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-0008
Mailing Address - Country:US
Mailing Address - Phone:704-332-3308
Mailing Address - Fax:704-332-3358
Practice Address - Street 1:1928 RANDOLPH RD
Practice Address - Street 2:STE. 206
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1105
Practice Address - Country:US
Practice Address - Phone:704-332-3308
Practice Address - Fax:704-332-3358
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22208207V00000X
VA0101037694207V00000X
WI48288-020207V00000X
IL036-103874207V00000X
MN45318207V00000X
MI4301085899207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34674700Medicaid
NCD83405Medicare UPIN
WI008504001Medicare ID - Type UnspecifiedAPPLYING FOR NC PIN